A regular menstrual cycle is of 28 days, on average and the female has her periods for 3 to 5 days. Periods are considered irregular when the majority of cycles in the last 6 months are irregular. Females with irregular period cycles may have their periods infrequently, frequently, and may be very unpredictable.
Symptoms of Irregular periods
Regular periods last from 3 to 5 days and occur almost around the expected period date. A female with irregular periods may have spotting instead of periods, spotting or light bleeding between periods, early periods, or delayed periods. Irregular periods may have many causes including an underlying medical condition, other factors such as pregnancy, breastfeeding, use of hormonal birth control, etc, and psychological factors such as stress.
Typically, lengths of irregular periods cycle are-
- For adolescents: Period cycles outside 21–45 days
- For adults: Period cycles outside 24–38 days
- For adults: Period cycles that vary in length by more than 7–9 days
A female is always suggested to keep a rough track of her period cycle and note if she notices spotting between periods, red, pink or brown colored bleeding between periods or vaginal discharge and other unusual activities in the period cycle.
Causes of Irregular Periods
Below are some of the common causes of irregular periods. Different causes can cause different types of irregularities in the period cycles.
Disease-Related Causes of Irregular Periods
Polycystic ovary syndrome (PCOS)
PCOS is a hormonal disorder having irregular periods as the most common sign. If a female has PCOS, she may miss her periods or have heavy bleeding when she gets the next period.
Most uterine fibroids are noncancerous and range in size from the size of an apple seed to the size of a grapefruit.
Uterine fibroids can cause painful, heavy, and irregular periods. Most uterine fibroids do not require treatment. However, the symptoms caused due to uterine fibroids can be managed with over-the-counter medications. Fibroids can cause so heavy periods that the female may get anemic. In that case, the doctor may prescribe her iron supplements.
Endometriosis is the condition in which the tissues that line the inside of the uterus grow outside the uterus. This condition affects nearly 1 in 10 females of reproductive age.
Endometriosis causes heavy bleeding, prolonged periods, bleeding between periods, and may also cause very painful periods with severe menstrual cramps.
Pelvic Inflammatory Disease or PID
Pelvic inflammatory disease or PID is a bacterial infection that affects the female’s reproductive system. A female with PID may experience abnormalities with her period cycle and vaginal health such as heavy and foul-smelling vaginal discharge, irregular periods, pelvic pain, and pain in the lower abdominal.
A recent study conducted on women of different ages revealed that 44 % of females with irregular periods also had thyroid disorders.
Hypothyroidism (low levels of thyroid hormones in the body) can cause long, very heavy periods with increased cramping. On the other hand, hyperthyroidism (high levels of thyroid hormones in the body) can cause shorter and lighter periods.
Cervical, Uterine and Endometrial Cancer
Cervical, uterine, and endometrial cancers can cause changes to the menstrual cycle, including heavier, lighter or irregular periods. A female with any of these cancers may also experience spotting between periods.
Premature ovarian insufficiency
Premature ovarian insufficiency occurs in females under the age of 40 whose ovaries are unable to function normally. In the case of this condition, the period cycle stops, just like it happens in menopause. Females who are undergoing treatment for cancer with chemotherapy and radiation, have a family history of premature ovarian insufficiency or chromosomal abnormalities are more likely to have premature ovarian insufficiency.
Other Causes of Irregular Periods
Hormonal birth control
Hormonal birth control pills, IUDs, and rings can cause irregular periods. Birth control pills can cause lighter periods and spotting between periods. On the other hand, IUD can cause heavy bleeding. Hormone containing forms of birth control are likely to cause irregular periods.
Prolactin, the hormone responsible for the production of breast milk suppresses the reproductive hormones. As a result, the female may have irregular periods, very light periods, or no periods at all (while you are breastfeeding). Don’t panic, if you had a normal period cycle before pregnancy and breastfeeding, your periods will get normal after you stop breastfeeding.
Also Read- How does Pregnancy change the female?
Perimenopause is the phase before the female enters menopause. This phase usually begins around the age of 40, recent studies have revealed several factors that can cause early perimenopause. Fluctuating estrogen levels during perimenopause can cause abnormal and irregular periods cycles, with shorter or longer periods.
Also Read- Bleeding after Menopause
Obesity and Rapid weight gain
Obesity is a common cause of menstrual irregularity. Being overweight impacts the hormone and insulin levels, which can interfere with the period cycle. Rapid weight gain can also cause irregular periods.
Also Read- Obesity and fertility risks in women
Many studies and research have shown that stress can interfere with the menstrual cycle by temporarily interfering with the hormones that regulate the period cycle. Chronic stress, depression or anxiety can cause long-term problems in the period cycles. In most cases, periods return to normal after the stress decreases.
Extreme weight loss and eating disorders
Being underweight or rapid weight loss can cause the periods to stop. Insufficient intake of calories interferes with the production of the hormones needed for ovulation. This can cause no periods or irregular periods. Females with eating disorders such as bulimia are likely to have irregular or no periods at all.
Excessive exercise or an intense exercise routine can interfere with the hormones responsible for menstruation in females. Female athletes and those involved in intensive physical activities often have irregular menstruation cycles and may even develop amenorrhea (absence of periods). Reducing your training sessions and increasing your calorie intake can help restore periods caused due to excessive exercises.
Some medications can interfere with the menstrual cycle, including:
- Thyroid medications
- Hormone replacement therapy
- Blood thinners
- Epilepsy drugs
- Chemotherapy drugs
In case your medications are the reason behind irregular periods, your doctor may change your medications. Make sure to speak to your doctor about this.
Treatment for Irregular Menses
Treatment for irregular periods depends on the cause. Below are the treatments options to treat irregular periods:
Treatment of the underlying disease or condition- Treating the underlying disease-causing irregular periods can help regulate the irregular periods.
Hormonal Therapy- The menstrual cycle can be regulated with hormones like estrogen. Females having irregular periods due to hormonal changes or imbalance may be suggested hormone therapy to regulate periods.
Lifestyle changes- In case the female is obese, underweight, have eating disorders, or has stress, coping with those conditions can help treat irregular periods. A female should also adopt a healthy lifestyle and quit smoking, usage of drugs, and excessive drinking. Eating healthy foods and moderate exercise can also be beneficial.
Surgery: In cases where irregular periods are caused due to uterine fibroids, structural problems in the uterus or blockage of fallopian tubes, surgery may be needed.
Talk to our gynecologists for doubts, concerns, and treatment for irregular periods.